January 30, 2022Pakistan Journal of Medical & Health SciencesOpen Access

Phenylephrine and ephedrine were similarly effective in preventing hypotension during elective cesarean section under spinal anesthesia, with 65% of phenylephrine patients and 61.7% of ephedrine patients experiencing one or more hypotension episodes.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Hypotension during Cesarean Section under Spinal Anesthesia (n=120). Intervention: Phenylephrine vs. Ephedrine (10 mg prophylactic bolus and 5 mg rescue bolus IV). Primary outcome: Incidence of one or more hypotension episodes requiring rescue vasopressor (p=>0.05).

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Why the study?

Maternal haemodynamic variations are common during caesarean section under spinal anesthesia, and this study compared the effectiveness of phenylephrine versus ephedrine in preventing and treating hypotension and their fetal outcomes.

Does ephedrine compared to phenylephrine prevent hypotension and improve neonatal outcomes in pregnant women undergoing cesarean section under spinal anesthesia?

Population

120 ASA grade-I patients with normal single pregnancy over 36 weeks undergoing planned caesarean-section

Comparison

Prophylactic and rescue ephedrine vs prophylactic and rescue phenylephrine

Design

Randomized trial

Key result

Phenylephrine and ephedrine were similarly effective in preventing hypotension during elective cesarean section under spinal anesthesia, with 65% of phenylephrine patients and 61.7% of ephedrine patients experiencing one or more hypotension episodes.

Authors

SCShahid Adalat ChaudhryDivisional Headquarters Teaching Hospital Mirpur MIMubashar IqbalUniversity of the Punjab MKMuhammad Nadeem KhanSoochow University

Discussion

Member takes

Overview

Either agent suits spinal hypotension management in cesarean delivery; confirms equivalent neonatal safety with phenylephrine-linked bradycardia.

Study Design

Type

RCT (n=120)

Blinding

Double-blind

Randomization

Randomized equally into 2 groups

Multicenter

Structured PICO

Does ephedrine compared to phenylephrine prevent hypotension and improve neonatal outcomes in pregnant women undergoing cesarean section under spinal anesthesia?

Population

120 ASA grade-I pregnant women with a normal single pregnancy over 36 weeks undergoing elective cesarean section under spinal anesthesia.

Intervention

Ephedrine (10 mg prophylactic IV bolus during intrathecal block, and 5 mg rescue bolus for maternal systolic BP <90 mmHg)

Comparator

Phenylephrine (100 µg prophylactic IV bolus during intrathecal block, and 50 µg rescue bolus for maternal systolic BP <90 mmHg)

Outcome

Hemodynamic variables (heart rate and blood pressure) documented every 2 minutes until birth and every 5 minutes thereafter, and incidence of hypotensionsurrogate

Main Result

Absolute Event Rate: 65% vs 61.7%

p-value: p=>0.05

Ephedrine and phenylephrine are equally effective in preventing and treating hypotension during spinal anesthesia for cesarean section, with no significant difference in fetal acidosis, though phenylephrine causes more bradycardia.

Cite This Study

Chaudhry et al. (2022) conducted an RCT in Hypotension during Cesarean Section under Spinal Anesthesia (n=120). Phenylephrine vs. Ephedrine (10 mg prophylactic bolus and 5 mg rescue bolus IV) was evaluated on Incidence of one or more hypotension episodes requiring rescue vasopressor (p=>0.05). Phenylephrine and ephedrine were similarly effective in preventing hypotension during elective cesarean section under spinal anesthesia, with 65% of phenylephrine patients and 61.7% of ephedrine patients experiencing one or more hypotension episodes.

synapsesocial.com/papers/6a93014bd10fd8fa3bf0b276 https://doi.org/10.53350/pjmhs22161967

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January 30, 2022Pakistan Journal of Medical & Health SciencesOpen Access

Phenylephrine and ephedrine were similarly effective in preventing hypotension during elective cesarean section under spinal anesthesia, with 65% of phenylephrine patients and 61.7% of ephedrine patients experiencing one or more hypotension episodes.

View Full Paper

Ask AI

Bookmark

Why the study?

Does ephedrine compared to phenylephrine prevent hypotension and improve neonatal outcomes in pregnant women undergoing cesarean section under spinal anesthesia?

Population

120 ASA grade-I patients with normal single pregnancy over 36 weeks undergoing planned caesarean-section

Comparison

Prophylactic and rescue ephedrine vs prophylactic and rescue phenylephrine

Design

Randomized trial

Key result

Authors

SCShahid Adalat ChaudhryDivisional Headquarters Teaching Hospital Mirpur MIMubashar IqbalUniversity of the Punjab MKMuhammad Nadeem KhanSoochow University

Discussion

Member takes

Overview

Either agent suits spinal hypotension management in cesarean delivery; confirms equivalent neonatal safety with phenylephrine-linked bradycardia.

Study Design

Type

RCT (n=120)

Blinding

Double-blind

Randomization

Randomized equally into 2 groups

Multicenter

Structured PICO

Does ephedrine compared to phenylephrine prevent hypotension and improve neonatal outcomes in pregnant women undergoing cesarean section under spinal anesthesia?

Population

120 ASA grade-I pregnant women with a normal single pregnancy over 36 weeks undergoing elective cesarean section under spinal anesthesia.

Intervention

Ephedrine (10 mg prophylactic IV bolus during intrathecal block, and 5 mg rescue bolus for maternal systolic BP <90 mmHg)

Comparator

Phenylephrine (100 µg prophylactic IV bolus during intrathecal block, and 50 µg rescue bolus for maternal systolic BP <90 mmHg)

Outcome

Hemodynamic variables (heart rate and blood pressure) documented every 2 minutes until birth and every 5 minutes thereafter, and incidence of hypotensionsurrogate

Main Result

Absolute Event Rate: 65% vs 61.7%

p-value: p=>0.05

Cite This Study

synapsesocial.com/papers/6a93014bd10fd8fa3bf0b276 https://doi.org/10.53350/pjmhs22161967

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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